Groups continue to ask HCFA for changes in OASIS report
Groups continue to ask HCFA for changes in OASIS report
By MATTHEW HAY
Healthcare InfoTech Staff Writer
WASHINGTON The home care industry is hoping Congress will force the Health Care Financing Adminis tration (HCFA; Baltimore) to make further changes in its Outcome and Assessment Information Set (OASIS). But while some members of the House Ways and Means health subcommittee members reportedly asked the agency to postpone OASIS by a full year, HCFA is not saying much at the moment.
Earlier this month, a senior HCFA official said that the agency does not plan to receive non-Medicare information until it is capable of encrypting it, but that change has not been formally released by the agency. Days later, HCFA was prompted by a growing concern over patient privacy to delay the transmission of all OASIS data beyond the April 26 date specified in its regulation.
Before the agency can accept OASIS data, it must establish "a system of records" that define the routine uses for this data. No new transmission date was specified, but the new system must be published in the Federal Register at least 30 days before HCFA can require agencies to start doing so.
"On the Republican side, I am hearing rumors that there might be a bill or a request that HCFA go back and certify that every question is necessary," a House Ways and Means health subcommittee aide told Healthcare InfoTech. "There is certainly a lot of agitation out there about OASIS." He said that Sub committee Chairman Rep. Bill Thomas (R-CA) and ranking member Rep. Pete Stark (D-CA) are not currently working together on any specific request. "That doesn’t mean that a junior member might not easily get 10 or 15 signatures on something that would delay it for a year or delay it until HCFA really needs the data for a [prospective payment system]," the aide added.
In the meantime, home care representatives are pressing HCFA for clarification on whether or not they should continue to encode data for both Medicare and non-Medicare patients. "There is still a lot of speculation that HCFA will not require agencies to report data for non-Medicare patients once HCFA starts accepting OASIS data," said one industry representative who has been consulting with HCFA on this issue on a regular basis. At the moment, the agency appears uncertain about the course it will ultimately chart.
In a directive earlier this month, HCFA instructed state and regional offices "not to cite non-compliance with OASIS requirements at this time." The agency added that "during this period of early implementation, it is important that surveyors recognize HHAs’ current ability to comply with the OASIS regulations and provide education where needed." However, in the interim, HCFA has yet to instruct agencies about how to encode OASIS data, and that has left them in a confusing position.
If agencies continue encoding OASIS data on all patients and HCFA does decide to exclude non-Medicare patient information, the agencies will be forced to open each record and remove all non-Medicare data before transmitting, explained one industry representative. Agencies also could opt to collect OASIS data on all patients but encode only the data for Medicare and Medicaid patients, the representative said. But this might be even riskier because if HCFA’s new regulation does require data on all patients to be transmitted, agencies would have to enter any backlog of paper records before transmitting any data.
In addition, despite HCFA’s instruction to its surveyors not to cite agencies for noncompliance, the instruction does not address the encoding issue and some observers believe that could leave agencies vulnerable from a compliance perspective.
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